An Investigation of Executive Functioning in Pediatric Anxiety.
Anxious kids plan slowly and stop often, yet switch rules faster—factor these EF twists into your sessions.
01Research in Context
What this study did
Stewart et al. (2018) compared anxious kids with calm kids on four thinking skills. They used lab games to test planning, stopping, switching, and memory.
All kids were in middle or high school. The team wanted to see which skills anxiety hits hardest.
What they found
Anxious kids took longer to plan and stopped themselves more often. Surprisingly, they switched rules faster than calm kids.
Working memory was only slightly worse. The picture is mixed: some skills lag, one skill leaps.
How this fits with other research
Omer et al. (2021) saw the same link in kids with motor problems: weak thinking skills led to more worry. Hinze et al. (2026) later showed the path runs the other way too—better skills now predict better mood one year later.
Stewart et al. (2018) also studied autistic kids and found big brain reactions to mistakes when social anxiety was high. Together these papers say anxiety can both hurt and be hurt by thinking skills, across diagnoses.
Anderle et al. (2025) seems to clash: they found autistic kids with poor flexibility had more traits. E et al. found anxious kids had better flexibility. The gap is about group and measure—autism studies use parent reports; anxiety study used speeded games. Speed can look like flexibility but isn’t the same as everyday adaptability.
Why it matters
When you write a behavior plan, expect anxious learners to pause longer before starting and to over-use self-corrections. Give them extra wait time and clear step cues. Use their fast rule-switching strength by mixing tasks to keep engagement high. Do not assume slow work means lack of knowledge—it may be the anxiety talking.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a 3-second wait prompt before each instruction and praise quick rule switches to harness their strength.
02At a glance
03Original abstract
Although science's understanding (e.g., etiology, maintaining factors, etc.) of pediatric anxiety and related problems has grown substantially over recent years, several aspects to anxiety in youths remain elusive, particularly with relation to executive functioning. To this end, the current study sought to examine several facets to executive functioning (i.e., cognitive flexibility, inhibition, planning, working memory) within a transdiagnostic sample of youths exhibiting varying degrees of anxiety symptoms. One hundred six youths completed a comprehensive battery, including several self-report measures (e.g., Multidimensional Anxiety Scale for Children [MASC] or MASC-2) and an automated neurocognitive battery of several executive functioning tasks (Intradimensional/Extradimensional [IDED], Stop Signal [SST], Spatial Span [SSP], Stockings of Cambridge [SOC] tasks). Regression analyses indicated that youths exhibiting marked anxiety symptoms demonstrated increased planning time and probability of inhibition compared with youths with minimal or no anxiety symptoms. Youths with marked anxiety symptoms similarly demonstrated better cognitive flexibility (i.e., set shifting) compared with youths with minimal anxiety. In addition, analyses indicated a trend such that youths exhibiting marked anxiety symptoms demonstrated poorer working memory compared with youths with no anxiety symptoms. Group classification did not predict remaining outcomes. Limitations and future areas of research are discussed.
Behavior modification, 2018 · doi:10.1177/0145445517749448